British Endodontic Society

Further information

The myths about root canal treatment

Research overwhelmingly proves that root canal treatment is safe, effective and eliminates pain. The American Association of Endodontists’s Root Canal Safety page provides further resources about the safety of endodontic treatment.

How many appointments are necessary for root canal treatment?

Sometimes root canal treatment is completed in one appointment but usually two or three visits may be necessary.

How long will the tooth last following root canal treatment?

With proper restoration and care your tooth it may last a lifetime after root canal treatment. Proper dental care includes regular brushing and flossing, proper diet and periodic dental check-ups.

Does endodontic therapy hurt?

With the use of modern techniques, root canal therapy typically involves little or no discomfort. Often there is pain before treatment and endodontic therapy provides relief.

Will there be pain after procedure?

Cleaning the root canals may cause some slight tenderness but usually over-the-counter pain killers alleviate the discomfort. If pain persists or if you experience severe pain, call your dentist.

How much does endodontic treatment cost?

The expense of an endodontic procedure varies depending on how severe the problem is and the type of tooth Molars with two or three canals are more difficult to treat and the fee will therefore be more. Endodontic treatment is usually more economical in the long term than any other alternative treatment.

What are the alternatives to endodontic treatment?

The alternative to endodontic treatment is extraction of the tooth. Loss of a tooth could create a functional problem such as chewing or an aesthetic problem. Restoring the lost tooth may involve the provision of a prosthetic replacement such as a denture, bridge or a dental implant the costs of which are variable.

Can all teeth be treated endodontically?

Occasionally a tooth cannot be saved. Endodontic treatment can be performed only if the root canals are accessible and can be adequately cleaned and sealed. The tooth must also have sufficient bone support. We only carry out treatment where we can give a good long term outlook.

Can the treatment fail?

Endodontic treatment can have success rate of up to 90% in general if carried out to a good standard allowing the tooth to remain in function. Problems can occur if the tooth develops decay or the restoration on the tooth fails, or on occasions despite good care the tooth may not heal as expected. Further endodontic treatment or surgery may be carried out if appropriate. A tooth that develops a crack can also be a cause of failure and may result in loss of the tooth.

Will I need to return for any additional treatment?

Your tooth should be examined at an interval after treatment to make sure that it has properly healed.

Want to know more?

If you have questions before or after your treatment, your dentist will be happy to talk to you.

What is Endodontic Retreatment?

Teeth that have had endodontic (root canal) treatment can last as long as natural teeth, however, in some cases the treatment can fail or symptoms can persist. This may happen shortly after the treatment has been performed or even years following the treatment.

In these cases it may be possible to carry out the treatment again, a procedure called endodontic retreatment.

Why does the treatment fail?

Endodontic treatment can fail for a number of reasons: It was not possible to treat narrow or curved canals well enough or the canals were not fully cleaned during the initial procedure. The tooth may have additional complicated anatomy that was not found on the initial treatment.

The final restoration was not placed quickly enough or the final restoration leaked due to a poor fit, fracture or recurrent decay around it.

Is retreatment more complicated than initial root canal treatment?

Retreatment is usually more complicated than initial root canal treatment as the tooth is normally fully restored with a permanent restoration. This can range from a simple restoration to a full coverage restoration such as a crown or as part of a bridge. In addition to this a post may have been placed inside the root prior to a final restoration being placed. This creates difficulty as access to the root canals is more difficult.
Additionally the canals will have been filled with root filling material and hence this has to be removed before they can be instrumented and cleaned again. All of these obstructions make the process more complicated.

Who does the retreatment procedure?

All dentists can carry out endodontic treatment but many prefer not to carry out retreatment procedures as this can be more challenging and may require additional equipment that may not be readily available.

Your dentist may opt to refer you to another practitioner who either has greater experience and training in the procedure or to a dedicated specialist endodontist for the procedure. A specialist endodontist is a practitioner who is registered and approved by the General Dental Council to carry out all forms of endodontic treatment. The endodontist will have more additional dental equipment that may facilitate the procedure.

What will happen if I am referred to an endodontist?

The endodontist will discuss with you the treatment options for your tooth. The endodontic procedure will be explained to you as well as the costs for the treatment.
What will happen during the retreatment?

If you decide on retreatment the endodontist will gain access to the root canals of the tooth to remove the root filling and clean the canals again prior to refilling the canals. In many cases the restoration on the tooth will have to be removed, including complex restorations such as crowns and posts to allow the procedure to be carried out.

Will the retreatment be successful?

Retreated teeth can function for many years if the reasons for the initial failure can be overcome. Advances in technology have allowed retreatment to be carried out on complicate problems but like most medical and dental procedures difficulties can prevent some teeth from responding to the treatment. The endodontist can advise on the likely success of the procedure and difficulties prior to the procedure.

How much will the procedure costs?

The cost of the retreatment is usually dependant on how complex the procedure might be but would normally cost more than the original root canal treatment.

What are the alternatives to retreatment?

Usually the alternatives would be removal of the tooth or endodontic surgery. Removal of the tooth would then leave a space that may or may not be acceptable functionally or aesthetically and perhaps would require a prosthetic replacement tooth in the form of a denture, bridge or implant. Endodontic surgery involves lifting the gum or gingival tissue after a small incision to allow access to the root tip that is the cause of the persistent problem. This root tip can then be treated and sealed. Endodontic surgery would allow the existing restoration to be retained, however retreating the canals is usually the first and best option. Your endodontist can advise on the particular options for your problem.